The operation of vagotomy alone or in combination with other gastric surgery has been carried out in 322 patients. Vagotomy alone was performed in 27 patients with peptic ulcer, but 10 of these required further surgery because of gastric retention. Vagotomy was done with subtotal gastric resection in 29 patients with peptic ulcer, with gastrojejunostomy in 93 patients, with duodenal ulcer, and with pyloroplasty in 162 patients with duodenal ulcer. The choice of operation depended on the patient's history. The explanation of varying postoperative results was therefore difficult, but the probability of good results was significantly higher when the combination of vagotomy and pyloroplasty was used. The operation of pyloroplasty affords the surgeon good visualization of the ulcer area at operation, is more effective in eliminating antral stasis and decreasing regurgitation of jejunal contents into the stomach, and facilitates subsequent operative procedures.
JAMA – American Medical Association
Published: Aug 29, 1959